O&P researchers comparing fabrication methods for lower-limb diagnostic sockets found that hand casting resulted in a more comfortable socket for the participants with transfemoral amputations and hydrostatic casting led to a more comfortable final socket for those with transtibial amputations.
The multisite, single-masked, randomized crossover trial involved a prosthetist at each site taking one cast by hand and another using hydrostatic casting. The process of casting, rectifying, and modifying a diagnostic socket was timed in minutes.
Eighty participants with unilateral lower-limb amputations were enrolled; 75 completed the study. The research team assessed the participants’ socket comfort scores during static fitting of the diagnostic socket before and after any modifications were made by the prosthetist.
The researchers found that the initial socket comfort score was significantly better in the transfemoral amputation group (n = 24) for the socket made from hand casting, and the final socket comfort score was significantly better in the transtibial amputation group (n = 51) for the socket made from hydrostatic casting. Total fabrication time for hydrostatic casting was significantly greater than hand casting, and it took significantly more time to cast and significantly less time to rectify with hydrostatic casting. There was no difference between casting approaches for time to modify the diagnostic socket. For both groups, hydrostatic casting took more total time than hand casting to fabricate a diagnostic socket, according to the study.
The open-access study, “Randomized crossover trial of hand and hydrostatic casting for custom lower limb prosthetic sockets: Assessing socket comfort and fabrication time,” was published in PLOS One.
